News: 2011, August 22nd

Featured Story

by Jessica Nelson

Child’s Play
Parent-Child Interaction Therapy

AUBURN – Carisa Wilsie is not your average small-town girl. She hails from Cordell, Oklahoma, but works with people from all over the country – and beyond – with the clinical psychology program at Auburn. Working with Dr. Elizabeth Brestan-Knight, Carisa is embodying the spirit of Auburn as they reach out to teach community workers the principles and practice of Parent-Child Interaction Therapy (PCIT).

PCIT is a two-pronged approach to child behavior disorders that focuses on first establishing positive feelings for the parent and child in a play-only situation. The therapy then capitalizes on that nurturing environment to move to a discipline phase. The idea us that once there is an overall feeling of warmth and the child enjoys being with the parent, then the discipline is more effective. What makes PCIT particularly unique is that it is definitely made possible by modern technology. The clinician will first train the parent, and then will monitor the parent as he or she uses the lessons with the child. With a bug in the parent’s ear and a two-way mirror, the child may often not be aware of the third party’s presence for most of the therapy.

Though PCIT as a therapy is well-established in the psychological community, and supported by evidentiary studies, there is a new movement afoot to put these therapies in the hands of community members who work directly with families and children. Wilsie finds this part exciting, and it will in fact be the basis for her dissertation – moving the therapy out of the controlled lab setting and making it more available to people. Furthermore, though PCIT was initially conceived as a tool to help parents learn to cope with behavioral disorders, research has shown that it is effective with situations involving physical child abuse.

Though Wilsie has herself worked clinically with more behavioral disorders, her research and her passion lies with ways to address child maltreatment. Says Wilsie, “Basically they don’t know how to handle a child that’s misbehaving, so [with PCIT] we teach them a more effective way rather than hurting their child.”

Dissemination work that is currently being undertaken in many universities involves taking PCIT to the community. Clinicians, like Carisa and Dr. Brestan-Knight, train community counselors on how to use PCIT with their clients. It is this service provided by Dr. Brestan-Knight’s lab that has attracted attention from community groups locally, nationally, and internationally. Carisa said their group has worked with the National Child Advocacy Center in Huntsville, Alabama, as well as another Child Advocacy Center in Georgia. But then they started receiving other requests.

They’ve worked with groups from Maryland, Cincinnati, and Singapore. The training involves an intensive 40-hour workshop given over five days. Dr. Brestan-Knight and members of her team have trained groups here at Auburn as well as on-site where the training was requested, but the farthest afield they have gone is Singapore.

The group requesting training from Singapore was a group of medical social workers from a women and children’s hospital. Their constituency was often-low income, and they couldn’t afford to come to Auburn for training. Would it be possible, they asked, to have Dr. Brestan-Knight come to them? They could scrape together funds to pay for one person’s travel.

Carisa says Dr. Brestan-Knight was excited about the opportunity, but didn’t think she could handle the burden of the training alone. She posed the idea to Carisa, and lined up funding from the Department of Psychology as well as the Committee on Community and Civic Engagement, one of the outreach arms of the College of Liberal Arts.

With Dr. Brestan-Knight, Carisa then traveled to Singapore to train therapists at the KK Women’s and Children’s Hospital. She can’t say enough good things about the experience. Not only were the professionals that they worked with extraordinarily gracious and hospitable, but it was exciting to work in such a different environment. As medical social workers, their charge is a little different than our social work profession. They generally worked in teams dedicated to certain groups. One team worked with women, another served children, another worked exclusively with child maltreatment. They handle medical problems as well as social problems, so they may be working with a behavior disorder, but one that was precipitated by the child losing an eye in a surgery. Or, for example, they might be working with a child who has an eating disorder and is being treated in the eating clinic.

“They had very different presenting problems than we’re used to seeing. It’s been interesting so far,” she says. All of the groups that they have trained stay in touch with the Auburn team in order to complete their requirements to be PCIT certified, and this is useful for research as well. Carisa and Dr. Brestan-Knight’s team has monthly, or sometimes more frequent, conference calls with each team, and they conduct tape reviews of client sessions. In other words, the clinics tape sessions with clients so that the Auburn group can monitor how well the counselors are using the skills that they have taught.

This is the principal thrust of Carisa’s dissertation research. They developed a training program for these groups, trained counselors, and now they are evaluating what works and what doesn’t in this dissemination work. “I’ve put a lot of work into this,” she says, “so it made sense for my dissertation.” And there is a dearth of material out there. Though others are conducting these kinds of training sessions, there has only been one study published. “This is what we need. The field needs to know,” Carisa says.

Meanwhile, Carisa is also applying for internships, working as the Clinic Coordinator for the Auburn University Psychological Services Center (AUPSC) as her practicum placement, and logging her own clinic hours. She’s quite busy, but seems to have more than enough energy to handle the workload.

Carisa’s undergraduate work was at Oklahoma Baptist University, in her home state. She majored in Psychology there, and found a volunteer placement the summer before her senior year at the University of Oklahoma Health Sciences Center, working with a center specializing in child abuse and neglect. This hospital was how she found Auburn, in fact. Dr. Brestan-Knight had been a post-doc there years before, and the staff there urged Carisa to seek her out. She did, applied to Auburn, and then she “came here for the interview and just loved it.”

For the future, Wilsie hopes to continue her clinical work and research in the area of child maltreatment. She knew early, working in a day care, that she would like to work in this field. “I felt like there was more going on in the homes of the children than I knew about,” she says. “I wanted to learn more about how to help these families.”